22, October 2007 Communication Arts 105 Instructor: Beadle The Ups and Downs of Bipolar Disorder How would you like to live your life on an emotional rollercoaster? Going back and forth between periods of extremely low moods to extremely high moods, never knowing how you are going to feel the next day or if you'll ever feel just right? For my birth father and many others that is their life because they have bipolar disorder. Bipolar disorder, also known as manicdepression, is a mood disorder in which a person alternates between episodes of major depression (extreme highs) and mania (extreme lows). According to a survey done by Dr. Ronald Kessler, bipolar disorder affects about 2.6% of the American population ages eighteen and up. Even though only a very small portion of the population is affected by this disorder, I felt personally inclined to learn more about it when I found out my birth father was actually diagnosed with the disorder. So today I'm going to explain to you what I learned about the symptoms of bipolar disorder and also what causes it and the treatments that are available. As I mentioned previously, bipolar disorder consists of alternating episodes of depression and mania. The length and time between these episodes vary from person to person. Some people have episodes that last just a few days whereas others have episodes that can last years. These episodes can cause great disturbances in the lives of those affected as well as their friends and family. While in the depressive stage, people with bipolar disorder have a lasting sad, anxious, or empty mood. They may experience feelings of hopelessness, pessimism, guilt, or worthlessness. Most people even lose pleasure in activities that they used to enjoy. Some
depressed people may become so sad that they will just spend all day in bed doing nothing. Many also experience a change in appetite, finding that they either eat too much or barely at all. If the depressive stage is really bad, they may experience recurring thoughts of suicide which can be very dangerous. However on the other hand, people in the manic stage experience periods of euphoria and other highs. These euphoric symptoms can be great! According to Ronald Comer author of the Fundamentals of Abnormal Psychology, a person in the throes of mania has active, powerful emotions in search of an outlet. However their mood of euphoria may be out of proportion with the actual happenings in the person's life. People may feel very optimistic and have an extreme self-esteem. They have a state of high activity and tend to talk rapidly, think rapidly, and move rapidly. Comer also states that flamboyance is not uncommon; they may dress in flashy clothes, give large sums of money to strangers, or even get involved in dangerous activities. Some bipolar people have even found they spark a creative side during their manic stages. An example of this is my birth father who has started a website where he posts poems, short stories, and notes about his thoughts during his manic stages. Although mania is usually considered to be the better of the two stages, there are still some symptoms that aren't so great. Some people become very irritable and may even exhibit very aggressive behavior that can harm others. They also may have poor judgment and make rash decisions. For example, during one of his manic episodes my birth father took off on a whim to California from Wisconsin and went on a huge shopping spree without telling his family or anyone! Also in both the manic and depressive stages, people with bipolar disorder may have difficulty concentrating, be very irritable as well as have disturbances in their normal sleep cycle, either sleeping too little or too much. However
it is good to know that people with the disorder can have periods of "normal" behavior between the depressive and manic stages. Now that we've learned the symptoms of bipolar disorder, let's see if we can try to understand what is at the root of it. Today the cause of bipolar disorder is still widely debated by many scientists. Some believe that the cause is biological. One study done by Post found that people with mania tend to have higher norepinephrine activity than depressed or controlled subjects. Norepinephrine is a neurotransmitter that is involved in the transfer of information in the brain. In another study done by Telner, patients with bipolar disorder were given a drug known to reduce norepinephrine activity in the brain and some of the patients found their manic symptoms had subsided. Other studies have found that people with bipolar disorder have membrane defects in their neurons, which are cells in the nervous system that process and transmit information. Also many brain imaging studies have found a number of abnormal brain structures in people with bipolar disorder although scientists do not yet know how these structures may affect bipolar disorder. Other experts believe that bipolar disorder may be inherited. Family studies done by Dr. Alan Swann found that identical twins of persons with a bipolar disorder have a 40% likelihood of developing the disorder as well; whereas fraternal twins and other siblings and relatives have only a 5 to 10% chance. So since my birth father has bipolar a disorder, I have a 5 to 10% chance of developing it as well. Although other scientists suggest that even though people may have a genetic predisposition for bipolar disorder, the environment people are raised in can affect whether or not that predisposition is actually converted into an actual disorder. So since I was not raised by someone with a bipolar disorder I may have a better chance of not developing it.
So now that you know a little more about what may cause bipolar disorder, let's talk about what we can do to treat it. Scientists have found that treatment can be difficult since the causes of bipolar disorder are not set in stone. However some treatments have been developed that seem to help those with the disorder. Today lithium, a silvery-white element, is a common prescription for people with bipolar disorders. Its effectiveness as a treatment was first discovered by Australian psychiatrist John Cade in 1949. However, even researchers today do not seem to totally understand how lithium works. They believe that it somehow changes synaptic activity in neurons of the brain and may also increase the activity of key proteins and other chemicals that work within specific neurons. This in turn may signal an increase in the health and functioning of the neurons therefore reducing the bipolar symptoms. Lithium seems to be more effective at treating the manic episodes but also can help those with a bipolar disorder to overcome their depressive episodes. According to study done by Carney and Goodwin more than 60% of patients with mania improve while taking lithium and most of them also find they experience fewer episodes as they continue treatment. Although lithium has been proven effective others find that that psychotherapy can also help. Psychotherapy is a treatment conducted by a therapist. The therapist helps the patient with bipolar disorder to recognize triggers that may possibly cause manic or depressive episodes. These triggers could be medication use or any emotional or physical change that occurs. The therapist will also help to provide strategies to help the patient manage stress, work out problems caused by the symptoms of the disorder, and possibly reduce the triggers. Psychotherapy seems to usually work best when combined with lithium as it helps to emphasize the importance of taking one's medicine continually.
In extreme cases some people find that electroconvulsive therapy or ECT may help control the symptoms associated with bipolar disorder. These extreme cases are ones where the person is having lots of suicidal thoughts or when no medicine has been proven effective. ECT is a procedure where electrodes are taped to your head and an electrical current is passed through to your brain for less than a second causing a brain seizure, as seen in this picture. According to Mayo Clinic Online, ECT profoundly affects brain metabolism and blood flow to various areas of the brain and that these changes somehow help to ease the symptoms of depression. So although this treatment can seem very scary it can be effective. Now as we have finally reached the end of this discussion on bipolar disorder, I hope you have learned something new. We have looked at the symptoms of bipolar disorder as well as the causes and treatment that are currently available, such as lithium, psychotherapy, and electroconvulsive therapy. Although it seems that there is a lot to be determined about bipolar disorder I now feel a little better knowing more about it as I could possibly inherit it from my birth father in the future.
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